中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
12期
1877-1879
,共3页
文辉%孔令贵%邢汉飞%杜宝青
文輝%孔令貴%邢漢飛%杜寶青
문휘%공령귀%형한비%두보청
呼吸衰竭%无创正压通气%肺疾病%慢性阻塞性
呼吸衰竭%無創正壓通氣%肺疾病%慢性阻塞性
호흡쇠갈%무창정압통기%폐질병%만성조새성
Respiratory failure%Noninvasive positive pressure ventilation%Pulmonary disease%Chronic obstructive
目的:观察无创正压机械通气治疗对老年人慢性阻塞性肺疾病并发呼吸衰竭患者临床疗效。方法收集64例老年慢性阻塞性肺疾病并发呼吸衰竭患者为研究对象,患者给予常规治疗,同时采用BiPAP 呼吸机经口鼻面罩行双水平无创正压通气治疗,并给予有效护理。治疗3 d 后,比较观察64例患者治疗前后 pH、PaO2、PaCO2、SaO2指标变化,呼吸、心率的变化及 APACHEⅡ、GCS 及辅助呼吸肌评分情况,记录通气治疗中不良反应。结果经过治疗后,患者的 pH 值由治疗前的(7.30±0.06),明显升高到(7.36±0.03),PaO2值由治疗前(43.58±5.54)mmHg,明显升高到(84.52±8.27)mmHg,SaO2值由治疗前(74.86±7.25)%,明显升高到(94.93±5.61)%,PaCO2值由治疗前(71.69±8.48)mmHg,明显降低到(42.55±6.23)mmHg,差异均有统计学意义(t =5.98、6.35、4.86、7.23,均 P <0.05),呼吸频率、心率均有明显改善,差异有统计学意义(t =4.87、5.32,均 P <0.05),APACHE Ⅱ、GCS 及辅助呼吸肌评分均有明显改善,其中APACHEⅡ、辅助呼吸肌评分显著降低,GCS 评分显著增加,差异均有统计学意义(t =4.09、4.01、4.33,均 P <0.05)。结论无创正压机械通气治疗能改善老年慢性阻塞性肺疾病并发呼吸衰竭患者临床症状,增加通气量及改善高碳酸血症,临床疗效较好,无严重不良反应。
目的:觀察無創正壓機械通氣治療對老年人慢性阻塞性肺疾病併髮呼吸衰竭患者臨床療效。方法收集64例老年慢性阻塞性肺疾病併髮呼吸衰竭患者為研究對象,患者給予常規治療,同時採用BiPAP 呼吸機經口鼻麵罩行雙水平無創正壓通氣治療,併給予有效護理。治療3 d 後,比較觀察64例患者治療前後 pH、PaO2、PaCO2、SaO2指標變化,呼吸、心率的變化及 APACHEⅡ、GCS 及輔助呼吸肌評分情況,記錄通氣治療中不良反應。結果經過治療後,患者的 pH 值由治療前的(7.30±0.06),明顯升高到(7.36±0.03),PaO2值由治療前(43.58±5.54)mmHg,明顯升高到(84.52±8.27)mmHg,SaO2值由治療前(74.86±7.25)%,明顯升高到(94.93±5.61)%,PaCO2值由治療前(71.69±8.48)mmHg,明顯降低到(42.55±6.23)mmHg,差異均有統計學意義(t =5.98、6.35、4.86、7.23,均 P <0.05),呼吸頻率、心率均有明顯改善,差異有統計學意義(t =4.87、5.32,均 P <0.05),APACHE Ⅱ、GCS 及輔助呼吸肌評分均有明顯改善,其中APACHEⅡ、輔助呼吸肌評分顯著降低,GCS 評分顯著增加,差異均有統計學意義(t =4.09、4.01、4.33,均 P <0.05)。結論無創正壓機械通氣治療能改善老年慢性阻塞性肺疾病併髮呼吸衰竭患者臨床癥狀,增加通氣量及改善高碳痠血癥,臨床療效較好,無嚴重不良反應。
목적:관찰무창정압궤계통기치료대노년인만성조새성폐질병병발호흡쇠갈환자림상료효。방법수집64례노년만성조새성폐질병병발호흡쇠갈환자위연구대상,환자급여상규치료,동시채용BiPAP 호흡궤경구비면조행쌍수평무창정압통기치료,병급여유효호리。치료3 d 후,비교관찰64례환자치료전후 pH、PaO2、PaCO2、SaO2지표변화,호흡、심솔적변화급 APACHEⅡ、GCS 급보조호흡기평분정황,기록통기치료중불량반응。결과경과치료후,환자적 pH 치유치료전적(7.30±0.06),명현승고도(7.36±0.03),PaO2치유치료전(43.58±5.54)mmHg,명현승고도(84.52±8.27)mmHg,SaO2치유치료전(74.86±7.25)%,명현승고도(94.93±5.61)%,PaCO2치유치료전(71.69±8.48)mmHg,명현강저도(42.55±6.23)mmHg,차이균유통계학의의(t =5.98、6.35、4.86、7.23,균 P <0.05),호흡빈솔、심솔균유명현개선,차이유통계학의의(t =4.87、5.32,균 P <0.05),APACHE Ⅱ、GCS 급보조호흡기평분균유명현개선,기중APACHEⅡ、보조호흡기평분현저강저,GCS 평분현저증가,차이균유통계학의의(t =4.09、4.01、4.33,균 P <0.05)。결론무창정압궤계통기치료능개선노년만성조새성폐질병병발호흡쇠갈환자림상증상,증가통기량급개선고탄산혈증,림상료효교호,무엄중불량반응。
Objective To investigate the clinical efficacy of noninvasive positive pressure ventilation for eld-erly patients with chronic obstructive pulmonary disease and respiratory failure.Methods A total of 64 elderly patients with chronic obstructive pulmonary disease and respiratory failure were collected.The patients were treated with conventional therapy,while using BiPAP ventilator line through the nose and mouth mask bilevel noninvasive pos-itive pressure ventilation therapy,and to give effective care.After treatment for 3d,the pH,PaO2 ,PaCO2 ,SaO2 index changes,respiration,heart rate changes and APACHE Ⅱ,GCS and accessory muscle score were observed.Adverse reactions were recorded.Results Before treatment the PH value of patient was (7.30 ±0.06),which significantly increased to (7.36 ±0.03 )after treatment,PaO2 values was significantly increased to (43.58 ±5.54)from (84.52 ±8.27),SaO2 value was significantly increased to (94.93 ±5.61)from (74.86 ±7.25),PaCO2 value from (71.69 ±8.48)decreased to (42.55 ±6.23).There was statistically significant before and after treatment (t =5.98,6.35,4.86,7.23,all P <0.05),respiratory rate,heart rate were significantly improved,showing a significant difference (t =4.87,5.32,all P <0.05 ),APACHE Ⅱ,GCS and accessory muscle scores were significantly improved,which APACHEⅡ,accessory muscle score was significantly lower,GCS score was significantly increased, were statistically significant (t =4.09,4.01,4.33,all P <0.05).Conclusion It shows that noninvasive positive pressure ventilation combined with conventional drug therapy can improve elderly patients with chronic obstructive pulmonary disease and respiratory failure in patients with clinical symptoms,increase ventilation and improve hyper-capnia,clinical efficacy is better,with no serious adverse reactions.